Validation of the ABCD-GENE score to identify high platelet reactivity in east Asian patients undergoing percutaneous coronary intervention

• Published in: International journal of cardiology Vol. 327; pp. 15 - 18
• Main Authors: Saito, Yuichi, Nishi, Takeshi, Wakabayashi, Shinichi, Ohno, Yuji, Kitahara, Hideki, Ariyoshi, Noritaka, Kobayashi, Yoshio
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 15-03-2021
• Subjects: ABCD-GENE score; Clopidogrel; Genetic testing; Risk factors; ABCD-GENE score; Clopidogrel; Genetic testing; Risk factors
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2020.11.022

High platelet reactivity (HPR) is associated with subsequent thrombotic events in patients undergoing percutaneous coronary intervention (PCI). Recently, the ABCD-GENE score was developed to identify patients at risk for HPR, incorporating both clinical and genetic factors. However, this score was derived and validated in mostly Caucasian subjects and it has not been validated in an East Asian population.
Individual patient data from 4 prospective studies were pooled, in which platelet reactivity was measured using the VerifyNow assay on clopidogrel and genotyping of CYP2C19 was performed after PCI. Study populations included patients with general stable coronary artery disease, hemodialysis, age ≥75 and/or body weight <50 kg, and acute coronary syndrome. VerifyNow P2Y12 reactivity units >208 was defined as HPR.
Of 184 patients, 111 (60%) had HPR on clopidogrel. In the receiver operating characteristics curve analyses, the ABCD-GENE score significantly predicted HPR on clopidogrel (AUC 0.78, best cut-off value 9, p < 0.001). Across the 4 studies and their combinations, the diagnostic ability and cut-off values of ABCD-GENE score for HPR on clopidogrel were consistent.
The ABCD-GENE score had significant and moderate diagnostic ability for HPR on clopidogrel in Japanese patients undergoing PCI. The predictivity was consistent across a broad spectrum of patient populations, suggesting the applicability of this novel scoring system in clinical practice worldwide.
•The ABCD-GENE score has been proposed to identify HPR on clopidogrel.•The ABCD-GENE score was developed in Caucasian populations.•Here, significant and moderate diagnostic ability of ABCD-GENE score in Japanese is shown.•The ABCD-GENE score may be useful in clinical practice worldwide.